What is it?
Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.
It is regarded as a risk factor for kidney disease because the heart and kidneys work very closely together. So if something goes wrong with the heart it can also lead to problems for the kidneys.
How the heart and kidneys work together
The kidneys can only filter the blood if there is enough blood passing through them. However, high blood pressure can damage the filters in the kidneys (called ‘glomeruli’).
The kidneys control the amount of salt and water in the bloodstream and, by sending chemical messengers (hormones) also control the contraction of the small arteries that set the blood pressure.
What happens when things go wrong?
If the heart stops pumping efficiently (‘heart failure’), chemical messengers are sent from the main veins to the kidneys, causing them to retain salt and water. This causes fluid build-up (oedema) and increased pressure in the main veins. Heart failure can also reduce the efficiency of kidney filtration, due to lower pressure in the arteries supplying the kidneys and higher pressure in the veins draining the kidneys.
Many types of kidney damage cause increased production of the hormones that control blood pressure, leading to high blood pressure (hypertension). This puts an additional strain on the heart and can, in the long run, cause heart failure. High blood pressure also increases the risk of damage to the arteries (atherosclerosis); coronary atherosclerosis can cause heart attacks.
“Atherosclerosis” is the technical term for a disease of arteries in which they become narrowed and inflamed with cholesterol deposits. In the heart, it causes heart attacks. In the brain, it causes strokes. When it affects the kidney arteries it can cause reduced blood supply to the kidneys (“renal artery stenosis’): this can cause reduced efficiency of kidney function and high blood pressure. Atherosclerosis can also cause a type of irreversible kidney damage called “cholesterol embolism”, when tiny fragments of diseased artery detach and then get stuck in the small blood vessels inside the kidney.
Causes of cardiovascular disease
Many different things can increase the risk of getting CVD. These include:
- High blood pressure
- Smoking
- High LDL-cholesterol (low-density lipoprotein)
- Diabetes
- Not taking enough regular exercise
- Being overweight or obese
- Having a family history of cardiovascular disease
- Diet – a healthy, balanced diet is recommended for a healthy heart
- Being of Afro-Caribbean or South Asian descent.
Ways to prevent cardiovascular disease
A healthy lifestyle can help to lower your risk of getting cardiovascular disease or help to stop the condition from getting any worse.
You can help yourself by:
- Not smoking – or trying to give up as soon as possible
- Having a balanced diet – with plenty of fibre, fruit and vegetables and low levels of salt, sugar and saturated fats
- Exercising regularly – at least 2 1/2 hours of moderate exercise a week, such as brisk walking, swimming or cycling.
- Maintaining a healthy weight – through a healthy diet and regular exercise
- Cutting down on alcohol.
Medication
Depending on your risk of cardiovascular disease, your GP may offer you
- Tablets to lower harmful cholesterol in the blood (usually ‘statins’)
- Tablets to lower blood pressure
- Nicotine replacement to help you stop smoking
- Aspirin (to reduce the risk of heart attacks)
Help for you
Speak to your GP if you want help and advice about preventing or managing cardiovascular disease (including advice on eating healthily, exercising and how to lose weight.
And always remember to speak to your kidney consultant or renal dietitian before starting a diet plan or new exercise programme if you are on a restricted diet due to kidney disease.
NHS - https://www.nhs.uk/conditions/Cardiovascular-disease/
British Heart Foundation Heart Matters magazine - https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/kidney-heart-link
Reviewed April 2019
Need for further research
We don’t yet fully understand why patients with kidney disease are so likely to develop cardiovascular disease. We need to work out the best treatments for people with heart disease and kidney disease and find effective ways of preventing and treating diseases of the kidney blood vessels.
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